• Utilization Nurse

    Beth Israel Lahey Health (Plymouth, MA)
    …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the ... severity of an array illnesses, intensity of service, and care coordination needs + Ability to identify appropriateness of patients admission and level of care needs (inpatient & observation) utilizing Interqual criteria + Knowledge of Interqual required;… more
    Beth Israel Lahey Health (08/15/25)
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  • Utilization Management Nurse

    CVS Health (Boston, MA)
    …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… more
    CVS Health (09/04/25)
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  • Registered Nurse - Utilization

    Beth Israel Lahey Health (Boston, MA)
    …lives.** Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status ... of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for… more
    Beth Israel Lahey Health (09/10/25)
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  • Registered Nurse ( Utilization

    Veterans Affairs, Veterans Health Administration (Leeds, MA)
    Summary This Registered Nurse position is in Nursing Service at the VA Central Western Massachusetts Healthcare System, located in Leeds, Ma. This is a full time 40 ... of healthcare services. Collaborate with multidisciplinary teams to ensure proper utilization of healthcare resources. Develop and implement UM policies and… more
    Veterans Affairs, Veterans Health Administration (09/10/25)
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  • Registered Nurse - Utilization

    Beth Israel Lahey Health (Plymouth, MA)
    …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the ... severity of an array illnesses, intensity of service, and care coordination needs + Ability to identify appropriateness of patients admission and level of care needs (inpatient & observation) utilizing Interqual criteria + Knowledged of Interqual required;… more
    Beth Israel Lahey Health (08/16/25)
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  • Complex Care Nurse Manager

    Lawrence General Hospital (Lawrence, MA)
    …referrals and facilitates appropriate discharge plans. + Works in conjunction with Utilization Review Nurse , Social Worker and Clinical Care Leader to ... As the Complex Care Nurse Manager provides evidence-based assessments, tools, information, and...setting with discharge planning, continuing care, care management, and utilization review. + Five years clinical nursing experience required… more
    Lawrence General Hospital (07/15/25)
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  • UM Behavioral Health Nurse

    Humana (Boston, MA)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support ... communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments… more
    Humana (09/09/25)
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  • Manager, Prior Authorization RN

    Fallon Health (Worcester, MA)
    …a clinical setting required. + Minimum of three to five years' experience as a utilization nurse in a payer or facility setting highly preferred. + Discharge ... appropriate, timely turnaround times are met + Creates and disseminates all required utilization reports on a daily, monthly, quarterly and annual basis. + Maintains… more
    Fallon Health (08/14/25)
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  • Registered Nurse -Inpatient CLC

    Veterans Affairs, Veterans Health Administration (Bedford, MA)
    Summary Registered Nurse -Inpatient CLC positions at the Bedford Healthcare System. This position is full-time 40 hours per week. This is an open continuous ... as vacancies become available. This OCA may be used to fill a Registered Nurse (RN) position that is located in the one of following services and specialties:… more
    Veterans Affairs, Veterans Health Administration (06/26/25)
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  • Registered Nurse , Part-Time

    Fenway Health (Boston, MA)
    Registered Nurse , Part-Time Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type Part-time Description As a Registered ... Nurse (RN) at Fenway Health you will provide compassionate,...patient, and other care team members. + Influences appropriate utilization of healthcare resources by helping to coordinate patient… more
    Fenway Health (07/02/25)
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